Cornelia (72 years old)

Cornelia, a 72-year-old retired naval officer, presented with episodes of macroscopic haematuria.

Assessment summary:

• Medical history:
  • Hypertension
  • Moderate chronic obstructive pulmonary disease
• ECOG PS: 1
• Cystoscopy:
  • 2 papillary tumours: 1 in the trigone, 1 in the right bladder wall
  • Largest tumour diameter: 3.5 cm
• Urine cytology: HG UCa (according to the Paris system)
• Conventional TURBT: resection visually complete, pathological review:
  • pTa HG
  • Pure UCa
  • No LVI
  • Muscle in specimen
• CT urography: cN0, no concomitant upper tract tumour

BCG induction was started. After the third dose of BCG induction, the patient presents with a strong, persistent urge to urinate, a burning feeling when urinating and microscopic haematuria without fever or other systemic symptoms. The patient was put on non-steroidal anti-inflammatory drugs (NSAIDs), but symptoms did not improve after 1 week.

A urine sample is collected and sent to the lab to be cultured.